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Administrative Assistant – Integrated Networks | AHCA/NCAL is seeking an Administrative Assistant to improve lives by delivering solutions for quality care. This role will provide administrative support for the Integrated Networks team.
Qualifications & Skills:
Bachelor’s degree considered in lieu of experience. Outstanding computer skills, including mastery of standard Microsoft Office products. One to three years of office experience required.
Duties & Responsibilities:
- Providing administrative support to Integrated Networks team, including expenses, scheduling, maintaining shared folders.
- Credentialing process, which includes;
- Providing outreach via phone call and/or email to retrieve credentialing documentation.
- Researching in databases and online to help fill in the gaps during the process.
- Following up with providers if there are missing or expired documents.
- Completing and submitting credentialing applications to payers.
- Maintaining master spreadsheets, to include data entry of initial data, updates, terminations, and ensuring accuracy of data.
- SharePoint site maintenance, including posting regular updated content.
- Auditing/researching payer directories to confirm facility network status.
- Other administrative duties as assigned.
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Clinical Care Manager (Florida) – Integrated Networks | AHCA/NCAL is seeking a Clinical Care Manager to improve lives by delivering solutions for quality care by providing clinical consulting and support services to AHCA/NCAL Solutions contracted networks.
Qualifications & Skills:
Bachelor’s degree required. Clinical training, registered nurse with MDS and/or survey management, preferred. Minimum five years’ work experience in healthcare setting, post-acute/long term care preferred. Experience in an association or other membership organization preferred. This position requires 10-25% travel within Florida.
Duties & Responsibilities: - Identify, define, and participate in quality improvement initiatives that improve quality outcomes and provider performance in value-based managed care contracts.
- Provide network members with the information, tools, and resources to comply with network quality program and quality contracts.
- Assist network member providers in implementing care protocols and meeting quality goals.
- Provide in-person training and educational sessions.
- Identify, develop, and participate in measuring adherence to quality program requirements development by individual networks, which may include clinical protocols, quality measurement, or other requirements.
- Develop strategies, initiatives, and projects to improve how care is delivered and measured.
- Provide guidance to network facility staff to administer high caliber patient care on a consistent basis.
- Staff network quality committees, providing clinical leadership, expert knowledge, analysis, and support to facilitate achievement of committee goals. Present to state and/or national conferences and conventions in areas of expertise.
- Other special projects and duties as assigned.
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Research Analyst – Research Department | This position improves lives by delivering solutions for quality care by supporting the Research Department’s efforts to provide data to internal and external stakeholders to improve the lives of residents, families, and staff in nursing homes and assisted living communities. This position will be responsible for maintaining and updating standardized deliverables, in addition to completing ad-hoc requests and analyses, to help shape public policy and regulations.
Qualifications & Skills: Bachelor’s degree required; Master’s degree preferred. Ideally in Economics, Public Health, Public Policy, Public Administration, Health Administration, or other related health care field. One to three years of experience in a quantitative research field, which can include graduate coursework and internships.
Duties & Responsibilities: Applicants must be able to manipulate and summarize data to support the department’s objectives. The analyst will be responsible for the following: - Importing and formatting data into our star schema data warehouse. This includes assisting in completing the paperwork to purchase certain datasets.
- Updating programs and reports on a routine basis.
- Receiving data requests from internal and external customers and ensure they are completed with assistance from others or by oneself.
- Summarizing metrics on quality, finance, and other topics in writing and graphs.
- Other duties as assigned.
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Senior Director of Credentialing & Provider Relations – Integrated Networks | AHCA/NCAL is seeking a Senior Director of Credentialing & Provider Relations to improve lives by delivering solutions for quality care by directing all credentialing functions for provider networks. The position is responsible for oversight and management of the credentialing team. Qualifications & Skills:
10+ years of project management experience with demonstrated success achieving goals. Personnel management experience required. Experience managing state and/or federal compliance processes required. Experience in health care and/or provider/payer credentialing required. College degree preferred, but experience in lieu of degree considered.
Duties & Responsibilities:
- Direct all credentialing activity of the network or networks.
- Supervise and lead credentialing team members.
- Provide guidance and education to members on credentialing issues as needed.
- Oversee process for management of credentialing and contracting applications as well as claims escalation process.
- Work collaboratively with payers, including on payment resolution and necessary project management to resolve provider payment issues.
- Provide oversight for management and storage of credentialing and other provider information.
- Manage fee invoicing process for all networks.
- Other duties as assigned.
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Senior Director of National Contracting – Integrated Networks | AHCA/NCAL is seeking a Senior Director of National Contracting to improve lives by delivering solutions for quality care by managing the day-to-day value based contracting of AHCA/NCAL Solutions contracted network(s). The position is responsible for contract negotiations, developing value-based programs, Contracting Committees, and contract implementation. Qualifications & Skills:
Bachelor’s degree required; graduate degree in related field preferred. A minimum of ten years of health care experience required. Post-acute care knowledge required. Network Development, payer contract, payer negotiation experience required. Value Based Reimbursement experience preferred. Project management experience required. Ability to effectively prioritize, plan, manage and execute a variety of projects required.
Duties & Responsibilities:
- Lead and manage contract negotiations with payers and lead messenger model activities as required, facilitate contract implementation, and manage existing contracts.
- Negotiate profitable health plan contracts in accordance with AHCA and industry standards.
- Negotiate contracts with evergreen terms that include annual rate increases in accordance with Medical Consumer Price Index guidelines.
- Design, negotiate and implement innovative contract arrangements including Value Based Contracts, episodic and case rate terms, and other contracts that reward provider performance.
- With the Sr. Director of Network Management, establish positive payer relationships through a system of key account management and regular scorecard reviews.
- Educate members on contract terms, policies and procedures and other functions of the network.
- Provide regular reports and establish and lead Contracting Committees for various state networks.
- Other special projects and duties as assigned.
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Summer Intern – Public Affairs | AHCA/NCAL is seeking a Summer Intern to help further the organization’s mission to improve lives by delivering solutions for quality care. This role will support the Public Affairs team and long-term care profession in various ways and gain visibility into the inner workings and aspects of the Public Relations field.
Requirements:
Currently pursuing a degree in communications, journalism, public relations, marketing, filmmaking, digital media, graphic design, or a related field. Excellent writing and verbal communications skills required. The candidate should be a self-starter, willing to learn and work on several projects at once and work under tight deadlines. Willingness to take responsibility and initiative to learn new things. Must have the ability to show good judgment, effectively respond and problem solve.
Duties will include:
Depending on skillset, this individual will assist with communications tasks including, but not limited to: writing and editing, photo and video production and editing, web and social media analytics, social media content, graphic design, media relations, event support and other communications and administrative support tasks as assigned. Applicants with 2-3 of these skills preferred.
The internship will last for eight weeks starting after the Memorial Day Holiday and pays $20/hour.
APPLY TODAY! | | | |
Summer Intern – Quality & Regulatory Affairs | AHCA/NCAL is seeking a Summer Intern to help further the organization’s mission to improve lives by delivering solutions for quality care. This role will support the Quality & Regulatory Affairs department by conducting research and providing support to the team.
Qualifications & Skills:
Junior or Senior college student preferred. Excellent computer skills including Outlook, Word, Excel and PowerPoint. Previous work, marketing, and research experience.
Duties & Responsibilities:
- Conduct basic research on regulations and enforcement actions for specific focused areas.
- Compile findings into presentable formats to include presentations and/or proposals.
- Support the development and promotion of educational resources for the Quality Award program.
- Other duties as assigned.
The internship will last for eight weeks starting after the Memorial Day Holiday and pays $20/hour.
APPLY TODAY! | | | |
Summer Intern – Reimbursement Policy |
AHCA/NCAL is seeking a Summer Intern to help further the organization’s mission to improve lives by delivering solutions for quality care. This role will support the Reimbursement Policy department by conducting research and providing support to members.
Qualifications & Skills:
Junior or Senior college student preferred. Excellent computer skills to include excel and PowerPoint. Previous work and research experience.
Duties & Responsibilities:
- Conduct basic research on state features such as demographics, Medicaid program policy, and Medicaid spending.
- Assist in development of member web resources.
- Support on population health management initiatives.
- Other duties as assigned.
The internship will last for eight weeks starting after the Memorial Day Holiday and pays $20/hour.
APPLY TODAY! | | | |
| AHCA/NCAL is seeking a Summer Intern to help further the organization’s mission to improve lives by delivering solutions for quality care. This role will support collecting, analyzing, and summarizing long-term care data to support advocacy and quality improvement efforts in nursing homes at the national level. Qualifications & Skills:
Junior or Senior college student preferred. Minimum of 1 year of office experience preferred. Outstanding computer skills and experience with SAS or another statistical software is a plus.
Duties & Responsibilities:
- Find relevant peer-reviewed and white papers on post-acute care issues, such as staffing and quality.
- Gather data from federal websites and other internet sources to create databases.
- Synthesize data and findings verbally and in writing.
- Other duties as assigned.
The internship will last for eight weeks starting after the Memorial Day Holiday and pays $20/hour.
APPLY TODAY! | |
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